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Wilderness: Ciguatera Toxin (cont.)

IN THIS ARTICLE

Ciguatera Fish Poisoning (Toxin) Treatment

There is no specific antitoxin available for ciguatera toxin.

  • Some investigators have suggested vomiting should be induced if the victim is awake and alert and has eaten ciguatera toxin-containing fish within the last 3 to 4 hours. Ipecac, a substance that causes vomiting, was suggested as the medication to use, but many investigators now think ipecac causes too much dehydration. Currently some physicians recommend gastrointestinal decontamination with activated charcoal. Activated charcoal may absorb the toxin if done 3 to 4 hours after ingestion.
  • Maintain hydration. Intravenous fluids may be necessary for uncontrollable nausea and vomiting.
  • No specific antidote is available.
  • Osmotic diuretics have been used to decrease symptoms (for example, mannitol [Osmitrol]).
  • Amitriptyline (Elavil, Endep) and gabapentin (Neurontin, Gralise, Horizant) may help reduce neural pain symptoms
  • Diphenhydramine (Benadryl) and hydroxyzine (Atarax, Vistaril) may help relieve itching.
  • NSAID's and acetaminophen (Tylenol and others) may reduce pain
  • Avoid alcohol, fish, nuts, and nut oils after exposure to ciguatera toxin because they may trigger recurrent symptoms.

When to Seek Medical Care for Ciguatera Toxin Poisoning

  • Severe cases require hospitalization for intravenous fluids.
  • Immediate medical attention is necessary for all cases because the symptoms may rapidly progress in a few patients.
  • A doctor should be consulted about treatment with available medications. If necessary a doctor specializing in poisonings (toxicologist) can be consulted.

Ciguatera Toxin Detection

Although some tests report the ability to detect this toxin in food, there are no officially sanctioned tests for ciguatera toxin available. Research is ongoing; investigators are researching the possibility of using monoclonal antibodies to both detect the toxin and to use the antibodies to treat patients.

Medically reviewed by Avrom Simon, MD; Board Certified Preventative Medicine with Subspecialty in Occupational Medicine

REFERENCES:

MedscapeReference.com. Ciguatera Toxicity in Emergency Medicine Clinical Presentation.


Medically Reviewed by a Doctor on 9/30/2016

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